Technique Guide 4.5 mm LCP Proximal Femur Plates. Part of the Synthes Periarticular LCP Plating System.
Table of Contents Introduction 4.5 mm LCP Proximal Femur Plates 2 AO Principles 4 Indications 5 Surgical Technique Preparation 6 Reduce Fracture 7 Insert Guide Wires 8 Insert Proximal Screws 10 Approximate Plate to Femoral Diaphysis 12 Insert Cortex Screws 13 Insert Locking Screws 14 Insert Cannulated Locking Screws 16 Implant Removal 17 Tips 18 Product Information Implants 19 Instruments 21 Set Lists 24 Image intensifier control Synthes
4.5 mm LCP Proximal Femur Plates The Synthes LCP Proximal Femur Plate is part of the LCP Periarticular Plating System, which merges locking screw technology with conventional plating techniques. The LCP Periarticular Plating System is capable of addressing complex fractures of the proximal femur with the 4.5 mm LCP Proximal Femur Plates and Proximal Femur Hook plates, complex fractures of the distal femur with the 4.5 mm LCP Condylar Plates, and complex fractures of the proximal tibia with the 4.5 mm LCP Proximal Tibia and LCP Medial Proximal Tibia Plates. The locking compression plate (LCP) has Combi holes in the plate shaft that combine a dynamic compression unit (DCU) hole with a threaded locking hole. The Combi hole provides the flexibility of cortex screw or locking screw fixation. The Synthes LCP Proximal Femur Plate is a limited-contact stainless steel plate. The proximal portion of the plate is precontoured for the proximal femur. The two proximal screw holes are designed for 7.3 mm cannulated locking screws and the third locking hole is designed for 5.0 mm cannulated locking screws. The hole for 5.0 mm locking screws is angled so the screw trajectory converges with the proximal 7.3 mm screw. Improved proximal femoral fixation in osteoporotic bone is achieved by the screw angulation and the locking interface with the plate. The remaining screw holes in the plate shaft are Combi holes. This provides the surgeon with the flexibility to achieve plate-to-bone apposition as well as axial compression or angular stability. Note: For information on fixation principles using conventional and locking plate techniques, please refer to the Synthes Large Fragment Locking Compression Plate (LCP) Technique Guide. 2 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
Features Anatomically contoured to approximate the lateral aspect of the proximal femur Plates specifically designed for left or right femurs to accommodate average femoral neck anteversion Plate lengths allow spanning of the entire diaphysis in segmental fracture patterns Use of locking screws provides the option of an angularly stable construct independent of bone quality Plates can be tensioned to create a load-sharing construct Manufactured of implant quality 316L stainless steel The three proximal screw holes are at the following angles to the plate shaft: First proximal hole (7.3 mm), 95 Second proximal hole (7.3 mm), 120 Third proximal hole (5.0 mm), 135 The two proximal plate holes are threaded and accept 7.3 mm cannulated screws (locking, conical fully threaded, or conical partially threaded). The third locking hole is threaded to accept 5.0 mm cannulated locking screws. (Necessity of this screw is fracture configuration dependent and should be identified during preoperative planning). The holes in the shaft of the plate are Combi holes that accept 4.0 mm or 5.0 mm locking screws in the threaded portion of the hole and 4.5 mm cortex screws in the DCU portion. Synthes 3
AO Principles In 1958, the AO formulated four basic principles, which have become the guidelines for internal fixation. 1 Those principles, as applied to the 4.5 mm LCP proximal femur plate, are: Anatomic reduction Anatomic plate profile assists reduction of the metaphysis to the diaphysis and facilitates restoration of the neck-shaft angle by proper screw placement. Stable fixation The combination of conventional and locking plate fixation offers optimum fixation irrespective of bone density. Preservation of blood supply A limited-contact design reduces plate-to-bone contact and helps to preserve the periosteal blood supply. Early, active mobilization Plate features combined with AO technique create an environment for bone healing. 1. M. E. Müller, M. Allgöwer, R. Schneider, and H. Willenegger. Manual of Internal Fixation, 3rd Edition. Berlin: Springer-Verlag. 1991. 4 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
Indications The 4.5 mm LCP proximal femur plate is intended for fractures of the femur including: Fractures of the trochanteric region, trochanteric simple, trochanterodiaphyseal, multifragmentary pertrochanteric, intertrochanteric reversed or transverse or with additional fracture of the medial cortex Fractures of the proximal end of the femur combined with ipsilateral shaft fractures Metastatic fracture of the proximal femur Osteotomies of the proximal femur Also for use in fixation of osteopenic bone and fixation of nonunions or malunions Preoperative AP Follow-up lateral Follow-up AP Synthes 5
Preparation 1 Preparation Required set 01.240.201 Periarticular LCP Plating System, with 5.0 mm Locking Screws or 01.240.209 Periarticular LCP Plating System, with 4.0 mm Locking Screws Complete the preoperative radiographic assessment and prepare the preoperative plan. AP and lateral radiographs of the entire femur are necessary for complete evaluation. Traction radiographs and views of the contralateral femur are useful adjuncts in the planning process. When considering use of the 4.5 mm LCP proximal femur plate, identify proper placement of the three proximal screws. Use the AO preoperative planner kit and the 4.5 mm LCP proximal femur plate template to aid in planning the procedure. Determine plate length and approximate screw lengths and instruments to be used. Position the patient supine on a radiolucent operating table, or a fracture extension table for lower energy fracture settings. Fluoroscopic visualization of the femur in both AP and lateral views must be verified prior to patient draping. 6 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
Reduce Fracture 2 Reduce fracture Reduce the fracture using a fracture table, clamps, Schanz screws, or other conventional reduction techniques. Alternatively, provisional indirect fracture reduction may be facilitated by attaching the 4.5 mm LCP proximal femur plate to the proximal segment with appropriately oriented screws, and then to the diaphysis with plate holding forceps. Synthes 7
Insert Guide Wires 3 Insert guide wires and establish screw trajectories Instruments 310.243 2.5 mm Drill Tip Guide Wire 324.174 2.5 mm Wire Guide, for 5.0 mm screws 324.175 2.5 mm Wire Guide, for 7.3 mm screws Note: It is more important to properly place guide wires in the proximal femur (considering the desired screw positions) than it is to precisely match the contour of the plate to the anatomy of the femur. The ability to lock the screws to the plate obviates the need for precise plate contouring and compressing the plate to the bone. Before placing the plate on the bone, thread the wire guides into the plate holes for each of the three proximal locking screws. Use the 2.5 mm wire guide for 7.3 mm screws in the two proximal screw holes, and a 2.5 mm wire guide for 5.0 mm screws in the third locking screw hole. The wire guides can also be used as a manipulation aid for positioning the plate on the proximal femur. Using fluoroscopic image control (AP and lateral), insert a 2.5 mm drill tip guide wire through the wire guide in each of the three proximal locking holes. For proper screw measurement, guide wires should reach but not penetrate subchondral bone. 8 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
Placement of the proximal guide wire in the AP view is into the midportion of the inferomedial quadrant of the femoral head along a path subtending a 50 angle relative to the calcar femoralis. Guide wire placement in this manner will facilitate placement of the proximal locking screw at a 95 angle to the femoral shaft (Figure 1). 95 50 The proximal wire is ideally placed slightly posterior to central in the lateral view. This accommodates an anteverted position for the second guide wire and screw. Accurate positioning of the proximal guide wire (and ultimately the locking screw) assures frontal plane alignment (Figures 2 and 3). Before a drill tip guide wire is inserted into the second wire guide, verify correct sagittal plane alignment of the plate on the proximal femur. This usually requires both visual and fluoroscopic assessment and prevents an apex anterior deformity when the plate is attached to the diaphysis. When this alignment is satisfactory, insert the guide wires through the next two (distal) wire guides, maintaining biplanar fluoroscopic control. In some patterns, insertion of the third guide wire may have to be deferred until final reduction (and compression, where possible) has been achieved (Figure 4). Figure 1 Figure 2 Figure 3 Figure 4 Synthes 9
Insert Proximal Screws 4 Insert proximal 7.3 mm cannulated screw Instruments 310.632 5.0 mm Cannulated Drill Bit, for use with 7.3 mm screws 310.634 4.3 mm Cannulated Drill Bit, for use with 5.0 mm screws 314.05 Cannulated, Hexagonal Screwdriver 314.23 Cannulated, Hexagonal Screwdriver Shaft 319.701 Cannulated Screw Measuring Device 511.771* Torque Limiting Attachment, 4 Nm or 511.774 Torque Limiting Attachment, 4 Nm, for AO Reaming Coupler Using the cannulated screw measuring device, measure for screw length over the guide wire. Select the appropriate length 7.3 mm cannulated locking screw. Use the cannulated hexagonal screwdriver to remove the wire guide. Technique tip: The self-drilling, self-tapping flutes of the 5.0 mm and 7.3 mm screws make predrilling and pretapping unnecessary in most cases. In dense bone, the lateral cortex can be predrilled. If necessary, use the 5.0 mm cannulated drill bit for 7.3 mm screws or the 4.3 mm cannulated drill bit for 5.0 mm screws. Insert the screw, using fluoroscopy, with the cannulated hexagonal screwdriver or cannulated hexagonal screwdriver shaft. This screw, as with all locking screws not protected by a torque limiting attachment, may be inserted using power; however, final seating and tightening must be done manually. Once the screw has been locked to the plate, the guide wire may be removed. Note: Recheck each locking screw prior to closing to verify that the screws are securely locked to the plate. Screwheads must be flush with the plate in the locked position before they can be considered fully seated. * Also available 10 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
In some cases it may be necessary to pull the plate to the bone; if so, use a fully threaded 7.3 mm cannulated conical screw in the proximal screw hole. However, use caution to avoid changing the alignment of the guide wire with the conical screw. If malalignment occurs, it may preclude final exchange of the conical screw for a locking screw, and thereby weaken the overall strength of the plate construct. Important: It is always recommended to replace conical screws with locking screws to ensure angular stability. 5 Insert second 7.3 mm screw Insert the second 7.3 mm screw using the same technique as described in Step 4. Synthes 11
Approximate Plate to Femoral Diaphysis 6 Approximate plate to femoral diaphysis Instrument 321.12 Articulated Tension Device Secure the plate to the lateral femoral shaft with bone holding forceps, adjusting horizontal plane alignment (rotation) as appropriate. Length restoration and fracture reduction can be facilitated by a number of indirect means, including a fracture table, the articulated tension device, the large distractor, the large distractor/compressor, or a large external fixator. Judicious, soft tissue preserving, direct reduction techniques with clamps may also be appropriate in some cases. When the fracture pattern permits, a tensioning device should be applied to the end of the plate to tension the plate and compress the fracture. Note: Use the articulated tension device to realign the fragments, tension the plate, and compress the fracture to create a load-sharing construct. Alternatively, although less desirable, the plate can be used as a bridging construct in patterns with segmental comminution where plate tensioning cannot be accomplished. Articulated Tension Device 12 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
Insert Cortex Screws 7 Insert 4.5 mm cortex screws Instruments 03.010.150 Star/HexDrive Screwdriver, T25, 3.5 mm hexagonal 310.31 3.2 mm Drill Bit 319.10 Depth Gauge, for large screws 323.46 4.5 mm Universal Drill Guide Note: All 4.5 mm cortex screws must be inserted into the plate shaft before insertion of any locking screws in the plate shaft. Use the 3.2 mm drill bit through the 4.5 mm universal drill guide to predrill the bone. For the neutral position, press the drill guide down in the nonthreaded hole. To obtain compression, place the drill guide at the end of the nonthreaded hole away from the fracture. (Do not apply downward pressure on the spring-loaded tip). Measure for screw length using the depth gauge for large screws. Select and insert the appropriate length 4.5 mm cortex screw using the Star/ HexDrive screwdriver. Insert as many standard 4.5 mm cortex screws as necessary. Synthes 13
Insert Locking Screws 8 Insert 4.0 mm or 5.0 mm locking screws Instruments 03.010.150 Star/HexDrive Screwdriver, T25, 3.5 mm hexagonal 03.010.151 Star/HexDrive Screwdriver Shaft, T25, 3.5 mm hexagonal 310.31 3.2 mm Drill Bit or 310.431 4.3 mm Drill Bit 319.10 Depth Gauge, for large screws 324.176 3.2 mm Drill Guide, for 4.0 mm screws or 312.449 4.3 mm Threaded Drill Guide 511.771* Torque Limiting Attachment, 4 Nm or 511.774 Torque Limiting Attachment, 4 Nm, for AO Reaming Coupler Attach the appropriate drill guide to the locking portion of a Combi hole: Use the 3.2 mm drill guide when inserting 4.0 mm locking screws (green band) Use the 4.3 mm threaded drill guide when inserting 5.0 mm locking screws (blue band) Note: Use of the drill guide is required. It will center the drill bit in the threaded portion of the Combi hole to create a screw trajectory that ensures the screw properly engages the plate. Use the appropriate drill bit to drill to the desired depth: Use the 3.2 mm drill bit for 4.0 mm locking screws (green band) Use the 4.3 mm drill bit for 5.0 mm locking screws (blue band) Note: Holes for locking screws may be drilled unicortically or bicortically, depending on bone quality. * Also available 14 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
Drill Guide Size Drill Bit Size Screw Size (Drill Guide Part #) (Drill Bit Part #) Color Code 4.0 mm Locking 3.2 mm 3.2 mm Green (324.176) (310.31) 5.0 mm Locking 4.3 mm 4.3 mm Blue (312.449) (310.431) Remove the drill guide and measure screw length using the depth gauge. Insert the appropriate length 4.0 mm or 5.0 mm locking screw using the appropriate screwdriver. Warning: If the torque limiting attachment is unavailable, do not tighten locking screws to the plate using power. Perform final tightening by hand. Repeat as necessary to insert additional locking screws. Synthes 15
Insert Cannulated Locking Screws 9 Insert oblique 5.0 mm cannulated locking screw* Instruments 314.05 Cannulated Hexagonal Screwdriver 314.23 Cannulated Hexagonal Screwdriver Shaft 319.24 2.9 mm Cleaning Brush 319.461 2.5 mm Cleaning Stylet 319.701 Cannulated Screw Measuring Device Using the wire guide and guide wire previously inserted at this hole location, measure for screw length with the cannulated screw measuring device. The correct length measurement will place the screw at the tip of the guide wire. Screw length considerations: The angled 5.0 mm cannulated locking screw in the plate shaft is intended to converge with the 95, 7.3 mm screw to create a buttress which will provide additional stability. This convergence should occur when using a 5.0 mm locking screw that is 85 mm in length. Remove the wire guide and insert the appropriate length screw over the 2.5 mm guide wire and into the bone using the cannulated hexagonal screwdriver or cannulated hexagonal screwdriver shaft. Locking screws may be inserted using power equipment; however, final seating and tightening must be done manually. Important: Securely tighten all locking screws again before closing. * The need for this screw is fracture configuration dependent and should be determined during preoperative planning. 16 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
Implant Removal Implant removal To remove locking screws, unlock all screws from the plate and then begin to remove the screws completely from the bone. This avoids rotation of the plate when removing the last locking screw. Synthes 17
Tips Cleaning cannulated instruments Cleaning the cannulation in each instrument is imperative for proper function. Instruments should be cleared intraoperatively using the 2.5 mm cleaning stylet to prevent accumulation of debris in the cannulation and potential binding of the instruments about the guide wire. Instruments should be cleaned postoperatively using the stylet and the 2.9 mm cleaning brush. Preliminary plate shaft attachment Instrument 311.449 Push-Pull Reduction Device or 324.033* Pull Reduction Instrument, for LISS The pull reduction instrument can be used to approximate the plate shaft to the diaphysis and counteract medial diaphyseal displacement. Reduction and fixation If an extension table is used, careful traction should be applied to prevent the gastrocnemius muscle from pulling the distal fragment posteriorly or into hyperflexion. Posterior support of the distal fragment can assist reduction. Sagittal plane reduction may be facilitated using a Schanz screw as a joystick in the anterior cortex of the distal fragment. Insertion of a Schanz screw into the proximal fragment may also be helpful. Should it still be impossible to achieve fracture reduction, extend the incision to improve access. When using a radiolucent table, towel bumps can be used under the diaphyseal segment to help reduce the fracture in the lateral plane. Limb axis can be checked using the C-Arm and a cautery cord from the femoral head to the center of the ankle joint on an AP view. Use the C-Arm at the knee to check that the cord passes 10 mm medially to the center of the knee joint. Adjustment to varus-valgus reduction should be performed before locking screw placement in the malaligned fragment. Fractures not treated acutely should be placed in skeletal traction to maintain length until plate fixation can be performed. * Also available 18 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
Screws Used with the 4.5 mm LCP Proximal Femur Plates 4.0 mm Locking Screws Create a locked, fixed-angle screw/plate construct Threaded conical head Fully threaded shaft Self-tapping tip 4.5 mm Cortex Screws Compress the plate to the bone or create axial compression May be used in the DCU portion of the Combi holes in the plate shaft Self-tapping tip 5.0 mm Cannulated Locking Screws Create a locked, fixed-angle screw/plate construct Threaded conical head Fully threaded shaft Self-drilling, self-tapping tip 5.0 mm Cannulated Conical Screws Compress the plate to the bone and provide interfragmentary compression Smooth conical head Partially threaded shaft Self-drilling, self-tapping tip 5.0 mm Locking Screws Create a locked, fixed-angle screw/plate construct Threaded conical head Fully threaded shaft Self-tapping tip 7.3 mm Cannulated Locking Screws Create a locked, fixed-angle screw/plate construct Threaded conical head Fully threaded shaft Self-drilling, self-tapping tip Synthes 19
Screws Used with the 4.5 mm LCP Proximal Femur Plates continued 7.3 mm Cannulated Conical Screws Compress the plate to the bone Fully threaded shaft Smooth conical head Self-drilling, self-tapping tip 7.3 mm Cannulated Conical Screws, partially threaded Compress the plate to the bone and provide interfragmentary compression Partially threaded shaft Smooth conical head Self-drilling, self-tapping tip 20 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
Selected Instruments from Periarticular LCP Plating System (01.240.201) 03.010.150 Star/HexDrive Screwdriver 310.243 2.5 mm Drill Tip Guide Wire 310.31 3.2 mm Drill Bit 310.431 4.3 mm Drill Bit 310.632 5.0 mm Cannulated Drill Bit 310.634 4.3 mm Cannulated Drill Bit 312.449 4.3 mm Threaded Drill Guide Synthes 21
Selected Instruments from Periarticular LCP Plating System (01.240.201) continued 313.93 Solid Hexagonal Screwdriver, 4.0 mm width across flats 314.05 Cannulated Hexagonal Screwdriver, 4.0 mm width across flats 319.10 Depth Gauge, for large screws 319.701 Cannulated Screw Measuring Device 321.12 Articulated Tension Device 323.46 4.5 mm Universal Drill Guide 22 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
324.174 2.5 mm Wire Guide, for 5.0 mm screws 324.175 2.5 mm Wire Guide, for 7.3 mm screws 324.176 3.2 mm Drill Guide, for 4.0 mm screws 511.774 Torque Limiting Attachment, 4 Nm, for AO Reaming Coupler Synthes 23
4.5 mm LCP Proximal Femur Set (105.272) Graphic Case 690.381 4.5 mm LCP Proximal Femur Plate Set Graphic Case Implants 4.5 mm LCP Proximal Femur Plates Left Right Holes Length (mm) 242.102 242.802 2 139 242.104 242.804 4 175 242.106 242.806 6 211 242.108 242.808 8 247 242.110 242.810 10 283 242.112 242.812 12 319 242.114 242.814 14 355 242.116 242.816 16 391 Required Set 01.240.201 Periarticular LCP Plating System, with 5.0 mm Locking Screws or 01.240.209 Periarticular LCP Plating System, with 4.0 mm Locking Screws Recommended Additional Sets 105.90 Bone Forceps Set 115.400 Large Fragment LCP Instrument and Implant Set 115.700 Large Distractor Set 115.720 Large External Fixator Set with Self-Drilling Schanz screws Note: For additional information, please refer to package insert. For detailed cleaning and sterilization instructions, please refer to http://us.synthes.com/medical+community/cleaning+and+sterilization.htm or to the below listed inserts, which will be included in the shipping container: Processing Synthes Reusable Medical Devices Instruments, Instrument Trays and Graphic Cases DJ1305 Processing Non-sterile Synthes Implants DJ1304 Available nonsterile or sterile-packed. Add S to catalog number to order sterile product. 24 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
Periarticular LCP Plating System, with 5.0 mm Locking Screws (01.240.201) Graphic Cases and Screw Racks 60.240.201 Locking Periarticular Plating System Graphic Case 60.240.203 Screw Rack, for 4.5 mm cortex screws 60.240.204 Screw Rack, for 5.0 mm locking screws, with T25 StarDrive recess 60.240.205 Screw Rack, for 5.0 mm and 7.3 mm cannulated locking screws and 7.3 mm conical screws 60.240.206 Screw Rack, for 5.0 mm cannulated conical screws 60.240.208 Locking Periarticular Plating System Instrument Tray Instruments 292.652 2.0 mm Non-Colored Threaded Guide Wire, 230 mm, spade point, 10 ea. 03.010.150 Star/ HexDrive Screwdriver, T25, 3.5 mm Hexagonal, self-retaining 03.010.151 Star/HexDrive Screwdriver Shaft, T25, 3.5 mm hexagonal, self-retaining, 165 mm 310.243 2.5 mm Drill Tip Guide Wire, 200 mm, 10 ea. 310.31 3.2 mm Drill Bit, quick coupling, 145 mm 310.431 4.3 mm Drill Bit, quick coupling, 180 mm, for 5.0 mm Locking Screws 310.44 4.5 mm Drill Bit, quick coupling, 145 mm 310.632 5.0 mm Cannulated Drill Bit, quick coupling, 200 mm (short flute) 310.634 4.3 mm Cannulated Drill Bit, quick coupling, 200 mm (long flute) 310.99 Countersink, for 4.5 mm and 6.5 mm screws 311.44 T-Handle, with quick coupling 311.449 Push-Pull Reduction Device, for use with 4.5 mm LCP plates, 2 ea. 311.46 Tap for 4.5 mm Screws 312.449 4.3 mm Threaded Drill Guide, 4 ea. 312.48 4.5 mm/3.2 mm Insert Drill Sleeve Synthes 25
Periarticular LCP Plating System, with 5.0 mm Locking Screws (01.240.201) continued Instruments continued 313.93 Solid Hexagonal Screwdriver, 4.0 mm width across flats 314.05 Cannulated Hexagonal Screwdriver, 4.0 mm width across flats 314.11 Holding Sleeve 314.23 Cannulated Hexagonal Screwdriver Shaft, 4.0 mm width across flats 319.10 Depth Gauge, for 4.5 mm and 6.5 mm screws 319.24 2.9 mm Cleaning Brush 319.461 2.5 mm Cleaning Stylet 319.701 Cannulated Screw Measuring Device 321.12 Articulated Tension Device 321.16 Combination Wrench, 11 mm width across flats 323.46 4.5 mm Universal Drill Guide 324.174 2.5 mm Wire Guide, for 5.0 mm screws, 5 ea. 324.175 2.5 mm Wire Guide, for 7.3 mm screws, 2 ea. 324.176 3.2 mm Drill Guide, for 4.0 mm screws, 2 ea. 338.49 Large Quick Coupling 397.706 Handle, for AO Reaming Coupler Connection 511.774 Torque Limiting Attachment, 4 Nm, for AO Reaming Coupler Implants 4.5 mm Cortex Screws, self-tapping Length Length (mm) Qty. (mm) Qty. 214.814 14 4 214.844 44 4 214.816 16 4 214.846 46 2 214.818 18 4 214.848 48 2 214.820 20 4 214.850 50 2 214.822 22 4 214.852 52 2 214.824 24 4 214.854 54 2 214.826 26 6 214.856 56 2 214.828 28 6 214.858 58 2 214.830 30 6 214.860 60 2 214.832 32 6 214.862 62 2 214.834 34 6 214.864 64 2 214.836 36 6 214.866 66 2 214.838 38 6 214.868 68 2 214.840 40 6 214.870 70 2 214.842 42 6 26 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
Implants continued 5.0 mm Periprosthetic Locking Screws, self-tapping, with T25 StarDrive recess Length (mm) Qty. 02.221.508 8 2 02.221.510 10 2 02.221.512 12 2 5.0 mm Locking Screws, self-tapping, with T25 StarDrive recess Length Length (mm) Qty. (mm) Qty. 212.201 14 4 212.215 42 6 212.202 16 4 212.216 44 2 212.203 18 4 212.217 46 2 212.204 20 4 212.218 48 2 212.205 22 4 212.219 50 2 212.206 24 4 212.220 55 2 212.207 26 6 212.221 60 2 212.208 28 6 212.222 65 2 212.209 30 6 212.223 70 2 212.210 32 6 212.224 75 2 212.211 34 6 212.225 80 2 212.212 36 6 212.226 85 2 212.213 38 6 212.227 90 2 212.214 40 6 5.0 mm Cannulated Locking Screws Length Length (mm) Qty. (mm) Qty. 02.205.025 25 2 02.205.090 90 2 02.205.030 30 2 02.205.095 95 2 02.205.035 35 2 02.205.100 100 2 02.205.040 40 2 02.205.105 105 2 02.205.045 45 2 02.205.110 110 2 02.205.050 50 2 02.205.115 115 2 02.205.055 55 4 02.205.120 120 2 02.205.060 60 4 02.205.125 125 2 02.205.065 65 4 02.205.130 130 2 02.205.070 70 4 02.205.135 135 2 02.205.075 75 4 02.205.140 140 2 02.205.080 80 4 02.205.145 145 2 02.205.085 85 4 5.0 mm Cannulated Conical Screws Length Length (mm) Qty. (mm) Qty. 02.205.240 40 2 02.205.270 70 2 02.205.245 45 2 02.205.275 75 2 02.205.250 50 2 02.205.280 80 2 02.205.255 55 2 02.205.285 85 2 02.205.260 60 2 02.205.290 90 2 02.205.265 65 2 02.205.295 95 2 Available nonsterile or sterile-packed. Add S to catalog number to order sterile product. Synthes 27
Periarticular LCP Plating System, with 5.0 mm Locking Screws (01.240.201) continued Implants continued 7.3 mm Cannulated Locking Screws Length Length (mm) Qty. (mm) Qty. 02.207.020 20 2 02.207.085 85 2 02.207.025 25 2 02.207.090 90 2 02.207.030 30 2 02.207.095 95 2 02.207.035 35 2 02.207.100 100 2 02.207.040 40 2 02.207.105 105 2 02.207.045 45 2 02.207.110 110 2 02.207.050 50 2 02.207.115 115 2 02.207.055 55 2 02.207.120 120 2 02.207.060 60 2 02.207.125 125 2 02.207.065 65 2 02.207.130 130 2 02.207.070 70 2 02.207.135 135 2 02.207.075 75 2 02.207.140 140 2 02.207.080 80 2 02.207.145 145 2 7.3 mm Cannulated Conical Screws (1 ea.) Length (mm) Length (mm) 02.207.250 50 02.207.275 75 02.207.255 55 02.207.280 80 02.207.260 60 02.207.285 85 02.207.265 65 02.207.290 90 02.207.270 70 02.207.295 95 7.3 mm Cannulated Conical Screws, partially threaded (1 ea.) Length (mm) Length (mm) 02.207.450 50 02.207.475 75 02.207.455 55 02.207.480 80 02.207.460 60 02.207.485 85 02.207.465 65 02.207.490 90 02.207.470 70 02.207.495 95 222.578 5.0 mm Screw Nut, 2 ea. 28 Synthes 4.5 mm LCP Proximal Femur Plates Technique Guide
Also Available 5.0 mm Periprosthetic Locking Screws, self-tapping, with T25 StarDrive recess 02.221.514 14 mm 02.221.518 18 mm 292.20 2.0 mm Kirschner Wire, 150 mm, trocar point 311.66 Tap for 6.5 mm Cancellous Bone Screws 312.67 6.5 mm/3.2 mm Double Drill Sleeve 394.35 Large Distractor 397.705 Handle, quick coupling, for ComPact Air Drive Connection 398.81 Self-Centering Bone Forceps 398.813 Plate Holding Forceps with swivel foot 511.761 Large Quick Coupling 511.771 Torque Limiting Attachment, 4 Nm 60.240.207 Screw Rack for 6.5 mm Cancellous Bone Screws 690.407 Screw Rack, for 4.5 mm Cortex Screws Available nonsterile or sterile-packed. Add S to catalog number to order sterile product. Synthes 29
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